There's no magic bullet when it comes to fertility. All bodies are different. There are, however, some lifestyle changes you can make to get your body in the best shape it can be in if you're planning to get pregnant. Read on — we're going to break down the what and the why of them for you.
Consider folic acid
Folic acid is the synthetic form of folate, a vitamin (B9), found in foods such as dark, leafy greens, liver, asparagus, brussels sprouts, and eggs. It can be purchased as a dietary supplement. Folic acid plays a role in preventing birth defects, particularly those of the neural tube (such as spina bifida and anencephaly), and the Centers for Disease Control (CDC) recommends that women, regardless of whether or not they're planning to become pregnant, get 400 mcg of folic acid (in addition to consuming food with folate in it) throughout their reproductive years.
Low levels of folate have been associated with a higher risk of early miscarriage, according to one study of Swedish women by researchers at the Karolinska Institute in Sweden and at the National Institute of Child Health and Human Development. The study compared 468 women who had an early miscarriage (between six and twelve weeks gestation) to 921 women who were six to twelve weeks pregnant, asking them to provide information about reproductive and health histories, as well as blood samples to assess folate levels and smoking status. Ultimately, a folate deficiency was linked to a fifty percent increase in one's risk of early miscarriage.
Get your BMI within range
Your weight can affect your fertility. If your BMI (body mass index) is low (under 18.5), you might not be producing enough estrogen, which can result in irregular periods and/or total absence of menstruation (amenorrhea). Overexercising can also cause amenorrhea.
If your BMI is high (between 25 and 29, over 30), you also may have issues with ovulation and inconsistent periods, but also other conditions that might have a negative impact on getting pregnant, such as thyroid problems, insulin resistance (see below for more on this) and diabetes. Talk to your doctor about where your BMI is situated, and if need be, strategize with them to get things where they should be before you start trying to conceive. And remember, fertility isn't just a women's issue; cis-men with high BMI have been found to have lower sperm counts and lower sperm movement (also known as motility).
No matter when you quit smoking, it's a good move for fertility
Quitting smoking is hard, but quitting at any point is beneficial to your health and your fertility. The chemicals in cigarette smoke (nicotine, cyanide and carbon monoxide) can speed up the loss of eggs, and once those eggs are gone, there's no replacing them. These same chemicals negatively impact the quality of your eggs as well as the function of your ovaries and can result in earlier menopause. Smoking has negative effects on sperm as well — decreased quality, decreased ability to move, the inability to fertilize eggs, and an abnormal shape. Once one stops smoking, though, fertility improves, so don't hesitate to reach out for support if you need help quitting.
Get tested/treated for STIs
Sexually transmitted infections (STIs) are super common, and many people have them and don't know it. So while you're getting in tip-top shape, make sure that includes STI testing. When chlamydia and gonorrhea (the two most commonly reported notifiable diseases in the United States) go untreated, they can lead to pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes, ovaries and cervix. PID can lead to infertility if left untreated. Chlamydia can also cause infections in the fallopian tubes.
Keep in mind that some STIs like HPV and herpes, have no symptoms, which makes it extra important that your (and your partner) get tested for them. And if you do test positive, don't let the shame and stigma that still accompanies STIs stop you from seeking treatment for it. 30% of cases of female infertility in the United States are the result of damage to the fallopian tubes, which is often the result of STIs.
Insulin resistance is exactly what it sounds like, your body's cells don't respond to processing insulin, which is a hormone produced by the pancreas that helps control the amount of glucose (sugar) in your blood. When glucose builds up in your blood, it can lead to type 2 diabetes. Both insulin resistance and obesity can inhibit ovulation. Women with polycystic ovary syndrome (PCOS) are at a higher risk for insulin resistance, but PCOS doesn't necessarily cause insulin resistance. If you are having irregular periods or if your period has disappeared altogether, you should definitely talk to your doctor. Insulin resistance can be treated with medicine and exercise, and weight loss.
Stress is not your friend
There are a lot of good reasons to decrease your stress levels, and here's another one: stress can have a negative impact on your fertility. It's a double edged sword — thinking about fertility can be stressful, and yet, you should avoid stress when you're pregnant and when you're trying to get pregnant. A 2014 study suggests that when stress hormones, such as cortisol, are activated, they can actually inhibit the release of estrogen and testosterone, hormones that are super important to fertility. Managing stress on your own is hard, so don't hesitate to reach out for help, especially if you feel like your stress is inhibiting your daily life or affecting your physical health (panic attacks, insomnia, heart palpitations, etc).
You might have heard about water bottles and other containers going BPA-free and wondered what that means. BPA (bisphenol A) is an industrial chemical that's been used to make plastic since the 1960s. It's found in the packaging of many foods and beverages. BPA is part of a class of chemicals known as endocrine disruptors, which have been shown to cause fertility issues in mice and rat studies. "Experts in the space recommend a few steps to reduce your exposure such as not microwaving food in plastics and buying or storing foods in glass when possible," says Sharon Briggs PhD, Modern Fertility's head of Clinical Product Development.
About that morning coffee and those after work drinks...
The Mayo Clinic recommends limiting your caffeine consumption to one or two 6- to 8-ounce cups of coffee a day, and to consider eradicating alcohol entirely if you're planning on getting pregnant. What isn't clear is at what point you should stop/cut down — three months before you start trying? A year? If you're wondering, definitely bring this up with your health care provider to get more insight.
Here's what we know for sure: getting your hormones tested with Modern Fertility is a proactive thing you can do now! Knowing what your levels are will help you make decisions about having kids before you actually start trying, and feeling empowered is a lifestyle change we can really get behind.